Translation services are an essential part of providing fair access to health care
In June, the Migrant Workers Alliance for Change (MWAC) received a call from a hospital asking them to translate information from English to Spanish for one of their patients, a migrant farm worker who was in critical condition after contracting COVID-19. In a recent report, MWAC described how, before putting the man on a ventilator, the hospital needed his verbal consent, prompting their call to MWAC. Rather than using a qualified medical interpreter, a doctor had tried using the Google Translate app on his phone to communicate vital medical information to the patient. “When we spoke to the worker informing him about his choices and that he may not wake up again, he confirmed that no interpretation had been provided in the previous days,” said the report.
This incident highlights how crucial it is to have access to reliable translation services in medical settings, especially during COVID-19. Without access to translation and interpretation services, patients cannot be properly informed of their medical choices and are unable to give medical workers the information they need to provide the best treatment.
In Southwestern Ontario, where many migrant workers from Spanish-speaking countries work and live in close quarters, major outbreaks have cropped up on several farms due to unsafe conditions and inadequate access to care. On June 1, about 18 per cent of all COVID-19 cases reported in Windsor-Essex County were from migrant workers. Despite this, MWAC still received complaints from some workers who said that they were not able to access translation services in Spanish and English.
In the U.S., where the Hispanic community has been extremely hard hit by the virus, the need for translators is especially important. According to the CDC, people who are Hispanic and Latinx have a hospitalization rate that is over four times higher than non-Hispanic white people in America.
Though the connection between language ability and health is complex, research has shown that inadequate language accommodation could be linked to poor health outcomes overall. A study that tracked new immigrants across many different language backgrounds between 2000 and 2005 found that those with persistently limited official language proficiency reported higher incidences of poor health over a four-year period compared to new immigrants with more advanced language proficiency.
Other interrelated factors affecting new immigrants, such as housing access and education level, were also linked to the health outcomes reported. But because Canada’s health system is built for English and French speakers, new immigrants can be left out — especially during their first years in Canada. As researchers pointed out, language proficiency could directly impact a new immigrant’s ability to access health services, and therefore result in poorer self-reported health.
Medical translation seeks to bridge this health care gap by facilitating accurate communication between health-care workers and patients. During a pandemic, when the volume of sick people is greater and conditions for COVID-19-positive patients can change quickly, medical translators are especially important to ensure that patients can communicate their symptoms and understand their diagnoses.
As Natalya Mytareva, executive director of the US Certification Commission for Health Care Interpreters told Time magazine, “any good doctor is only as good as how they are understood by the patient.” Even the best medical treatment will be made ineffective without a full understanding between patient and doctor. “If the doctor is basing the diagnosis on the wrong information because they didn’t have an interpreter, then what good is that doctor?” said Mytareva.
As physical distancing measures continue to be put in place in hospitals, the family members and friends that might typically do the translation for people with limited official language proficiency are unable to accompany them to the hospital. Though patients should ideally not need to rely on family member’s assistance for translation, their absence in medical spaces has only further increased the demand for interpreters.
At the same time, interpreters’ ability to do their job is hampered during COVID-19. Many medical interpreters are now forced to do their work over the phone rather than in person, which can reduce the quality of translation they can provide to patients, like their ability to pick up on some of the non-verbal cues present during a conversation. Some interpreters have also described the trauma of doing their work during COVID-19, especially when they themselves are among the communities being hardest hit by the virus.
As the pandemic continues, governments should be making sure that no one in the country is left out when it comes to accessing essential services. And those essential services may not necessarily be limited to the health-care sector. Undocumented migrant workers fearing legal issues should be made aware that they are able to access health care if they contract COVID-19; new Canadians protesting in recent anti-racism and police violence demonstrations should be made aware of their legal rights if they’re arrested; and Canadians with limited language ability should not fall into the estimated 3 per cent of workers who did not know they were eligible for Canada Emergency Response Benefit payments.
Though offering translation services isn’t going to fix all of the systemic inequalities facing racialized communities — many of whom may come from immigrant backgrounds with limited language proficiency in English — they are essential to ensuring that everyone is able to access the services they need.